[Metabolic Syndrome in Portugal: Prevalence and Associated Factors]. / Síndrome Metabólica em Portugal: Prevalência e Fatores Associados.

INTRODUCTION: The metabolic syndrome consists of a set of factors that, when associated, are associated with a higher risk of developing cardiovascular diseases and type 2 diabetes, and is thus an important public health problem. The objective of this study was to estimate the prevalence of this syndrome in the Portuguese population, and to evaluate possible associations with demographic and socioeconomic determinants. MATERIAL AND METHODS: Based on the 1st National Health Survey with Physical Examination of 2015, a cross-sectional epidemiological study was conducted on a representative sample of the Portuguese population (n = 4797) aged between 25 and 74 years old. The prevalence was estimated for the total population and each gender, stratified by age group, health region, type of urban area, marital status, education, professional status, and risk of poverty. The magnitude of the associations was measured with adjusted prevalence ratios. RESULTS: In the Portuguese population the estimated prevalence was 33.4% [95% CI, 31.7 - 35.1] [35.6% in men (95% CI, 31.9 - 39.2) and 31.3% in women (95% CI, 28.5 - 34.2)]. In both genders, the highest prevalence was significantly associated with increasing age, widowed/married/de facto partners and those with lower levels of education. There was no association with gender, health region, type of urban area, professional status or risk of poverty. DISCUSSION: This syndrome was present in a third of the Portuguese population. The knowledge of its epidemiology enables the identification of population groups with higher cardiovascular and metabolic risk. CONCLUSION: Metabolic syndrome was independently associated with specific groups. This knowledge reinforces the importance of a holistic assessment of the health determinants associated with the metabolic syndrome.

Introdução: A síndrome metabólica consiste num conjunto de fatores que, quando associados, conferem maior risco de desenvolver doenças cardiovasculares e diabetes tipo 2, constituindo um importante problema de saúde pública. O objetivo deste estudo foi estimar a prevalência desta síndrome na população portuguesa, e avaliar possíveis associações com determinantes demográficos e socioeconómicos. Material e Métodos: Com base no primeiro Inquérito Nacional de Saúde com Exame Físico de 2015, realizou-se um estudo epidemiológico transversal numa amostra representativa da população portuguesa (n = 4797) entre os 25 e 74 anos. A prevalência foi estimada na população total e em cada sexo, estratificada por grupo etário, região de saúde, tipologia de área urbana, estado civil, escolaridade, situação profissional e risco de pobreza. A magnitude das associações foi medida pelas razões de prevalências ajustadas. Resultados: A prevalência estimada foi de 33,4% (IC 95%, 31,7 ­ 35,1) na população portuguesa [35,6% nos homens (IC 95%, 31,9 ­ 39,2) e 31,3% nas mulheres (IC 95%, 28,5 ­ 34,2)]. Em ambos os sexos, a maior prevalência estava significativamente associada ao aumento da idade, a indivíduos viúvos/casados/unidos de facto e com menor escolaridade. Não se verificou associação com sexo, região de saúde, tipologia de área urbana, situação profissional ou risco de pobreza.Discussão: Esta síndrome estava presente num terço da população portuguesa. O conhecimento da sua epidemiologia permite identificar grupos populacionais com maior risco cardiovascular e metabólico. Conclusão: A síndrome metabólica estava independentemente associada a grupos específicos. Este conhecimento reforça a importância de uma avaliação holística dos determinantes de saúde associados à síndrome metabólica.

"Truly holistic?" Differences in documenting physical and psychosocial needs and hope in Portuguese palliative patients.

OBJECTIVE: Palliative care (PC) aims to improve patients' and families' quality of life through an approach that relieves physical, psychosocial, and spiritual suffering, although the latter continues to be under-assessed and under-treated. This study aimed to describe the prevalence of physical, psychosocial, and hope assessments documented by a PC team in the first PC consultation. METHOD: The retrospective descriptive analysis of all first PC consultations registered in our anonymized database (December 2018-January 2020), searching for written documentation regarding (1) Edmonton Symptom Assessment Scale (ESAS) physical subscale (pain, tiredness, nausea, drowsiness, appetite, shortness of breath, constipation, insomnia, and well-being), (2) the single question "Are you depressed?" (SQD), (3) the question "Do you feel anxious?" (SQA), (4) feeling a burden, (5) hope-related concerns, (6) the dignity question (DQ), and (7) will to live (WtL). RESULTS: Of the 174 total of patients anonymously registered in our database, 141 PC home patients were considered for analysis; 63% were male, average age was 70 years, the majority had malignancies (82%), with a mean performance status of 52%. Evidence of written documentation was (1) ESAS pain (96%), tiredness (89%), nausea (89%), drowsiness (79%), appetite (89%), shortness of breath (82%), constipation (74%), insomnia (72%), and well-being (52%); (2) the SQD (39%); (3) the SQA (11%); (4) burden (26%); (5) hope (11%); (6) the DQ (33%); and (7) WtL (33%).Significant differences were found between the frequencies of all documented items of the ESAS physical subscale (29%), and all documented psychosocial items (SQD + SQA + burden + DQ) (1%), hope (11%), and WtL (33%) (p = 0.0000; p = 0.0005; p = 0.0181, respectively). SIGNIFICANCE OF RESULTS: There were differences between documentation of psychosocial, hope, and physical assessments after the first PC consultation, with the latter being much more frequent. Further research using multicenter data is now required to help identify barriers in assessing and documenting non-physical domains of end-of-life experience.